A Study on the Effect of Dietary Modifications in decreasing or delaying Radiation Induced Acute Gastrointestinal Adverse Events in patients receiving Pelvic Radiotherapy

2021 ◽  
pp. 4029-4034
Author(s):  
Devina Janeendran ◽  
Bhama Santhosh Kumar ◽  
Jiya Marium George ◽  
Ayana S. Kumar ◽  
Ram Madhavan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Radiation Therapy ◽  
Adverse Events ◽  
Treatment Modality ◽  
Dietary Intervention ◽  
Gastrointestinal Side Effects ◽  
Radiation Induced ◽  
Gastrointestinal Adverse Events ◽  
Dietary Modifications

Ionizing radiotherapy is a very common treatment modality for various types of cancer. However, its uses are expected to increase drastically with several advances in screening as well as early detection of cancer. Radiation injury due to radiation to the gastrointestinal tract is an imperative factor that works against better utility of this critical treatment modality. Moreover, following radiotherapy there are a higher chances of acute as well as chronic symptoms that would significantly reduce the quality of life of patients and furthermore adding an extra burden to the patients in terms of cost of healthcare. Thus interventions to reduce these adverse events can have long term benefits. Acute radiation induced gastrointestinal adverse events can be managed by modification of diet. Dietary modification of fat, lactose or non-starch polysaccharides (fibre) or combination of these dietary modifications reduces acute gastrointestinal adverse events during radiotherapy. In our study, we observed patients diagnosed with prostate and rectal cancer and those patients receiving neo adjuvant chemo-radiotherapy of rectum. The patients were advised to follow certain dietary modifications which aid in controlling the acute gastrointestinal side effects that developed after exposing to radiation therapy. The patients were followed up on a weekly basis and recorded the severity of the gastro intestinal symptoms after each cycle of radiation therapy and the quality of life was also calculated. Our study demonstrates that the dietary intervention appears to be a promising treatment option to control these adverse events. The dietary restriction of fat, fibre and lactose also helped in reducing the grades of adverse events during the radiotherapy. The Quality of Life of patients, however, after radiotherapy was found to be decreased when compared to the baseline.

scholarly journals Personal innovative approach in radiation therapy of lung cancer- functional lung avoidance SPECT-guided (ASPECT) radiation therapy: a study protocol for phase II randomised double-blind clinical trial

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Azza Ahmed Khalil ◽  
Eric Hau ◽  
Val Gebski ◽  
Cai Grau ◽  
Harriet Gee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Clinical Trial ◽  
Radiation Therapy ◽  
Radiation Dose ◽  
Pulmonary Toxicity ◽  
Double Blind ◽  
Curative Intent ◽  
Radiation Induced

Abstract Background Radiation therapy (RT) plays a key role in curative-intent treatment for locally advanced lung cancer. Radiation induced pulmonary toxicity can be significant for some patients and becomes a limiting factor for radiation dose, suitability for treatment, as well as post treatment quality of life and suitability for the newly introduced adjuvant immunotherapy. Modern RT techniques aim to minimise the radiation dose to the lungs, without accounting for regional distribution of lung function. Many lung cancer patients have significant regional differences in pulmonary function due to smoking and chronic lung co-morbidity. Even though reduction of dose to functional lung has shown to be feasible, the method of preferential functional lung avoidance has not been investigated in a randomised clinical trial. Methods In this study, single photon emission computed tomography (SPECT/CT) imaging technique is used for functional lung definition, in conjunction with advanced radiation dose delivery method in randomised, double-blind trial. The study aims to assess the impact of functional lung avoidance technique on pulmonary toxicity and quality of life in patients receiving chemo-RT for lung cancer. Eligibility criteria are biopsy verified lung cancer, scheduled to receive (chemo)-RT with curative intent. Every patient will undergo a pre-treatment perfusion SPECT/CT to identify functional lung. At radiation dose planning, two plans will be produced for all patients on trial. Standard reference plan, without the use of SPECT imaging data, and functional avoidance plan, will be optimised to reduce the dose to functional lung within the predefined constraints. Both plans will be clinically approved. Patients will then be randomised in a 2:1 ratio to be treated according to either the functional avoidance or the standard plan. This study aims to accrue a total of 200 patients within 3 years. The primary endpoint is symptomatic radiation-induced lung toxicity, measured serially 1–12 months after RT. Secondary endpoints include: a quality of life and patient reported lung symptoms assessment, overall survival, progression-free survival, and loco-regional disease control. Discussion ASPECT trial will investigate functional avoidance method of radiation delivery in clinical practice, and will establish toxicity outcomes for patients with lung cancer undergoing curative chemo-RT. Trial registration Clinicaltrials.gov Identifier: NCT04676828. Registered 1 December 2020.

scholarly journals Bevacizumab Combined with Corticosteroids Does Not Improve the Clinical Outcome of Nasopharyngeal Carcinoma Patients With Radiation-Induced Brain Necrosis

2021 ◽  
Vol 11 ◽  
Author(s):  
Honghong Li ◽  
Xiaoming Rong ◽  
Weihan Hu ◽  
Yuhua Yang ◽  
Ming Lei ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Nasopharyngeal Carcinoma ◽  
Adverse Events ◽  
Clinical Outcomes ◽  
World Health ◽  
World Health Organization Quality ◽  
Brain Necrosis ◽  
Radiation Induced

ObjectiveOur aim was to compare the clinical outcomes of patients treated with bevacizumab combined with corticosteroids and those with bevacizumab monotherapy from a radiation-induced brain necrosis (RN) registry cohort (NCT03908502).MethodsWe utilized clinical data from a prospective RN registry cohort (NCT03908502) from July 2017 to June 2020. Patients were considered eligible if they had symptomatic RN after radiotherapy for nasopharyngeal carcinoma (NPC) and received bevacizumab (5 mg/kg, two to four cycles) with a minimum follow-up time of 3 months. The primary outcome was a 2-month response rate determined by MRI and clinical symptoms. Secondary outcomes included quality of life [evaluated by the abbreviated World Health Organization Quality of Life (WHOQOL-BREF) questionnaire] and cognitive function (evaluated by the Montreal Cognitive Assessment scale) at 2 months, RN recurrence during follow-up, and adverse events.ResultsA total of 123 patients (34 in the combined therapy group and 89 in the monotherapy group) were enrolled in our study with a median follow-up time of 0.97 year [interquartile range (IQR) = 0.35–2.60 years]. The clinical efficacy of RN did not differ significantly between patients in these two groups [odds ratio (OR) = 1.642, 95%CI = 0.584–4.614, p = 0.347]. Furthermore, bevacizumab combined with corticosteroids did not reduce recurrence compared with bevacizumab monotherapy [hazard ratio (HR) = 1.329, 95%CI = 0.849–2.079, p = 0.213]. The most common adverse events of bevacizumab were hypertension (17.89%), followed by nosebleed (8.13%) and fatigue (8.13%). There was no difference in grade 2 or more severe adverse events between the two groups (p = 0.811).InterpretationOur results showed that the treatment strategy of combining bevacizumab with corticosteroids did not lead to better clinical outcomes for RN patients with a background of radiotherapy for nasopharyngeal carcinoma.

Prognostic factors affecting severity of radiation-induced fibrosis.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. e280-e280
Author(s):  
Ahmed M Maklad ◽  
Hanan Abdel-Rady Assaf ◽  
Essameldin Abdelaziz Nada ◽  
Ashraf Elyamany ◽  
Asmaa A Badran
Keyword(s):  
Quality Of Life ◽  
Radiation Therapy ◽  
Prognostic Factors ◽  
Cancer Survivors ◽  
Lower Limbs ◽  
Improve Quality ◽  
Factors Affecting ◽  
Detailed Medical History ◽  
Radiation Induced

e280 Background: Evaluation of prognostic factors affecting Radiation Induced Fibrosis (RIF) to help for decreasing its incidence and to improve quality of life for cancer survivors. Methods: Thirty patients were included in this study .It was carried out at faculty of medicine, Sohag University Hospital, Egypt during the period between July 2012 and July 2013 after approval of university ethical committee. We included all patients with (RIF) which is persistent or appeared after 6 months of completion of radiation therapy. Detailed medical history and clinical examination were done for all patients included in the study. We categorized the patients according to severity of RIF into four grades according RTO 2010. Assessment of pain was done according to 0–10 Numeric Pain Rating Scale. Results: Thirty patients with RIF were included in the study. The age of the studied patients ranged from 21- 65 years with a Mean 48,33 ± SD of 10,88. 56.7% of the cases were more than 50 years old. Female patients were 73.3%. BMI of the studied patients ranged from 19-40 kg/cm2 with a Mean 28.03 ± SD of 6.98. 26.7%patients were smokers.43.3% patientshadprevious history of acute radio dermatitis.60% had breast tumor. Chest was affected in 19 (60%) patients, back in 3 (10%) patients, neck in 4 (13%) patients, lower limbs in 2 (7%) patients, and face in 2 (7%) patients.T1 represented in 30%, T2 in 36.7%, T3 in 13.3% while T4 in 20% of the included patients. Twenty four (80%) patientsreceived chemotherapy before radiation. We documented a significant relation between BMI and severity of RIF (p = 0.007).Severity of RIF was significantly associated with higher BMI (p = 0.007), higher radiation doses (p = 0.02), higher number of radiotherapy treatment fraction (p = 0.03), higher radiation field sizes (p = 0.003), and patients with duration of more than one year of RIF (p < 0.001). Patients from rural areas documented higher degree of RIF (p = 0.03). Conclusions: It is important to give more attention to RIF as a one of late toxicity of radiation therapy. It can be minimized by avoiding its predisposing factors to improve quality of life of cancer survivors.

scholarly journals Radiation induced vesicovaginal fistula

2018 ◽  
Vol 13 (2) ◽  
Author(s):  
Kenusha Devi Tiwari
Keyword(s):  
Quality Of Life ◽  
Cervical Cancer ◽  
Radiation Therapy ◽  
Radical Hysterectomy ◽  
Vesicovaginal Fistula ◽  
Fistula Repair ◽  
Pelvic Radiation ◽  
Radiation Induced

Case: A 63 years old female visited our outpatient department for involuntary loss of urine per vagina since 1.5 year. She had undergone radical hysterectomy and radiotherapy 16 years ago for cervical carcinoma. With positive dye test, on examination she had vesicovaginal fistula with Goh classification of 2biii. She underwent fistula repair via vaginal approach. After 3 weeks of catheterization, successful closure was achieved. Radiation therapy is an effective treatment for cervical cancer. However, of various complications, irradiation sometimes cause the formation of fistula between vagina and bladder and or rectum compromising the quality of life. Pelvic radiation is the primary cause of delayed vesicovaginal fistula with incidence of 13%. Majority of them become apparent 1.5-2 year after termination of radiotherapy and can occur even up-to 20-30 years after the original insult. Keywords: cervical cancer, fistula, radiation induced

scholarly journals Gastrointestinal side effects of cancer treatments

2020 ◽  
Vol 11 ◽  
pp. 204062232097035
Author(s):  
Mary O’Reilly ◽  
Gregory Mellotte ◽  
Barbara Ryan ◽  
Anthony O’Connor
Keyword(s):  
Quality Of Life ◽  
Radiation Therapy ◽  
Side Effects ◽  
Cancer Survival ◽  
Survival Rates ◽  
Cancer Therapies ◽  
Cancer Treatments ◽  
Gastrointestinal Side Effects

Cancer survival rates have significantly improved over the last number of years due to advancements in cancer therapies. Unfortunately this has come at a cost. Therapeutic side effects are feared complications of therapy that may result in decreased quality of life and early cessation of the therapy, which can have knock-on effects on outcomes. This article outlines the main gastrointestinal side effects seen with radiation therapy, chemotherapy and immunotherapy, and discusses appropriate investigation and management.

Efficacy of proprietary Lactobacillus casei for anti-tuberculosis associated gastrointestinal adverse reactions in adult patients: a randomized, open-label, dose–response trial

2020 ◽  
Vol 11 (1) ◽  
pp. 370-377 ◽  
Author(s):  
Song Lin ◽  
Shanliang Zhao ◽  
Jiahong Liu ◽  
Jianwen Zhang ◽  
Chao Zhang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Adverse Events ◽  
Treatment Failure ◽  
Lactobacillus Casei ◽  
Adverse Reactions ◽  
Open Label ◽  
Label Dose ◽  
Gastrointestinal Adverse Events ◽  
Response Trial

Anti-tuberculosis (TB) drugs can induce a series of gastrointestinal adverse events, which can seriously affect patients’ quality of life and may lead to treatment failure.

scholarly journals COMPARISON OF THE EFFECTIVENESS OF PROTON AND PHOTON THERAPY IN PATIENTS WITH BRAIN TUMORS

2021 ◽  
Vol 20 (2) ◽  
pp. 127-135
Author(s):  
V. A. Solodky ◽  
T. R. Izmailov ◽  
P. V. Polushkin
Keyword(s):  
Quality Of Life ◽  
Overall Survival ◽  
Radiation Therapy ◽  
General Information ◽  
Photon Radiation ◽  
Radiation Toxicity ◽  
Who Grade ◽  
Huge Impact ◽  
Radiation Induced

Owing to the development of molecular genetics, the role of radiation therapy and chemotherapy in treatment of patients with glioma (WHO Grade I–IV) has become more understandable. The overall survival among glioma patients has increased. As overall survival increases, oncologists are more likely to detect manifestations of late radiation toxicity that has a huge impact on Quality of Life in patients who have undergone radiation therapy in the past. In this regard, the question of finding more adequate radiation therapy techniques remains relevant. photon radiation therapy is the standard method; however, considering dosimetric advantages of proton therapy over photon therapy, its widespread use can potentially lead to the increased overall survival, decreased number of late radiation-induced complications and improved quality of life in the post-radiation period. This article presents some comparative characteristics of proton and photon radiation therapy in patients with gliomas (WHO Grade I–IV). dosimetry characteristics of protons in tissues were compared, data showing differences in survival of patients treated with photons versus patients treated with protons were presented, and general information on early and late  radiation-induced toxicity arising from the treatment by these methods was disclosed.

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